TAILIEUCHUNG - Centers for Medicare & Medicaid Services: Medicaid Program; Recovery Audit Contractors

Localism and decentralisation can only work if central government is prepared to trust local bodies, communities and citizens. We have aimed to design a local audit system which provides the rigour needed for Parliament, but allows local public bodies to take more responsibility in the way they procure audit services. These changes go hand in hand with the Government’s actions to increase transparency in local government and will help enable local people and local organisations to hold their local public bodies to account for the way that their money is spent | AUTHENTICATED . GOVERNMENT INFORMATION z GPCT Vol. 76 Friday No. 180 September 16 2011 Part II Department of Health and Human Services Centers for Medicare Medicaid Services 42 CFR Part 455 Medicaid Program Recovery Audit Contractors Final Rules 57808 Federal Register Vol. 76 No. 180 Friday September 16 2011 Rules and Regulations DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare Medicaid Services 42 CFR Part 455 CMS-6034-F RIN 0938-AQ19 Medicaid Program Recovery Audit Contractors AGENCY Centers for Medicare Medicaid Services CMS HHS. ACTION Final rule. SUMMARY This final rule implements section 6411 of the Patient Protection and Affordable Care Act the Affordable Care Act and provides guidance to States related to Federal State funding of State start-up operation and maintenance costs of Medicaid Recovery Audit Contractors Medicaid RACs and the payment methodology for State payments to Medicaid RACs. This rule also directs States to assure that adequate appeal processes are in place for providers to dispute adverse determinations made by Medicaid RACs. Lastly the rule directs States to coordinate with other contractors and entities auditing Medicaid providers and with State and Federal law enforcement agencies. DATES Effective Date These regulations are effective on January 1 2012. FOR FURTHER INFORMATION CONTACT Joanne Davis 410 786-5127. SUPPLEMENTARY INFORMATION I. Background A. Current Law The Medicaid program is a cooperative Federal State program designed to allow States to receive matching funds from the Federal Government to finance medical assistance to eligible low income beneficiaries. Medicaid was enacted in 1965 by the passage of the Social Security Act Amendments of 1965 creating title XIX of the Social Security Act the Act . States may choose to participate in the Medicaid program by submitting a State Plan for medical assistance that is approved by the Secretary of the . Department of Health and Human Services. While States are not

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